Are On Obama Care? If so, how do you like it?

[Abraham]

Thanks all for your replies.

SA_Steve,

By cardio, I guess you're speaking of a cardiologist?

If so, the low cost of $0.08 / month is immaterial if you can't find a doctor to accept Obamacare. Right?

And, you point out the cost will accelerate in 2016. Wow!

From what your GF experienced it sounds like Obamacare is completely unworkable.

Do I have that right?

Thanks!

TAM,

You pay almost $8500.00 annually in premiums alone. That's hideously expensive. If you don't mind my asking, what's your deductible?

Have you had to get medical care under this plan and if so, how did it go?

Thanks!

RPBrown ,

I don't understand how they could double your monthly cost after four months.

Were you provided any justification for such an enormous increase over one that was very high to begin with? Also, did they increase the deductible?

Thanks!

[jmra]

Heard a story recently about someone on Obamacare would had to cancel a scheduled non life threatening surgery because they couldn't come up with the $10k out of pocket money.
Not sure how much good this "insurance" is.

[Abraham]

jmra,

I wonder if there is any group who actually benefits by being enrolled in Obamacare?

That is, a low monthly cost, low or no deductible and doctors who accept it?

Would this be the very poor or are they too suffering high monthly costs and huge deductibles thus making Obamacare unworkable for them as well?

[ShootDontTalk]

****** SNIP

That is why I cannot EVER agree that 90% of all democrats are anything other than selfish pudknockers, and the other 10% are so disrespectful that they think they have a god-given right to direct MY life. And ALL of them are costing me a lot of money. I curse their fecklessness.

Amen, Amen, and AMEN

Sadly many people are beginning to feel this way about ALL politicians.

[AJSully421]

I'm a health insurance agent. I have walked tons of people through Healthcare.gov and helped them get coverage, both with and without subsidies.

If you fall in the category where you can get a pretty good subsidy (like 50-75% of the cost) then it is ok. If not, then get an agent and go directly to the carrier (Blue Cross Blue Shield, Humana, UHC, Cigna) and get your coverage.

One thing that blows me away is anyone who says that their doctor or hospital refuses to take "Obamacare". Folks, a plan bought on the federal exchange with a subsidy is the exact same plan code, plan name, and plan number as a plan bought privately, off of the exchange, without any subsidy. The ID card looks exactly the same.

Now, if a person is very low income, and on the verge between qualifying for a 100% OC subsidy and going on full Medicaid, then there are cost sharing provisions that kick in that will reduce their out of pocket expenses. A provider can find out about that cost sharing and can then know that this is an "obamacare" policy.

As an agent, here is what I tell people... Go to Healthcare.gov, find the place where you can "estimate your health costs". Without logging in or in any way having to disclose your identity, you can estimate your potential subsidy by entering basic info such as county / zip code. age of everyone in your household, and total household income (If your 14 year old earns $200 per month on a paper route, then you need to add that amount in to the total) and it will estimate the amount of a subsidy that you could receive. Unless that number works out to be about $30 -40 per family member per month... it is better to go to the private market. Plans "on the exchange" carry an extra 5% tax on them. If the number is well above $50 per family member per month, then mosy likely it will be better for you to buy a plan on the exchange. The way that I always know is that I run it both ways. I will run a BCBS, humana and UHC quote on them and then go compare it to what it shows on that HC.gov estimator and can show them side-by-side which option is the best for them. I have never run into another agent who does both like this... and a few agents that I have talked to have scoffed at me for taking care of my clients and showing them all of their options... who doesn't want to know that their agent looked at all of the options?

Let me know if anyone has questions. Doing this and Medicare is my 80 hr/wk job.

[jmra]

jmra,

I wonder if there is any group who actually benefits by being enrolled in Obamacare?

That is, a low monthly cost, low or no deductible and doctors who accept it?

Would this be the very poor or are they too suffering high monthly costs and huge deductibles thus making Obamacare unworkable for them as well?

I don't know of any plan anywhere inside or outside Obamacare that meets all 3 of those requirements. We are seeing more and more of the home grown doctors moving to private practice and more doctors trained outside the states stepping in to fill the void. So I assume if you look hard enough you can find doctors that will sign up for plans as long as you don't care about their training or experience.

[Abraham]

jmra,

Thanks for your helpful input.

AJSully421,

Have you gotten any positive feedback regarding medical care from those on Obamacare? Or, are they suffering long waits in overcrowded conditions in clinics/hospitals?

Am I correct in assuming poverty level people are the ones to most benefit using Obamacare?

From what I gather too, (and correct me if I'm wrong) even lower middle class folk can't afford Obamacare.

Thanks!

[rotor]

Abraham, perhaps AJsully can chime in but I believe docs don't want to take Obamacare because even though you may have a card it is not proof that you have paid your premium and if the doc renders care such as major surgery and you have not paid the premium the doc does not get paid and he/she bites the bullet. Docs therefore don't want to take that risk and apparently there is no way for them to be sure that you have paid your premium and are up to date. I can understand why they feel the way they do. Obama built the program that way on purpose. With private insurance the doc just calls the insurance company and gets the OK right then and there. Not so with Obamacare.

[The Wall]

I don't use it and don't want to use it. What I've seen as a result of Obama care is it's hard to see a doctor unless you want to pay up front for the visit. Regardless of your insurance. The doctors office I have used for years let go all of the doctors and hired Nurse Practitioners. The doctor just oversees the operation. If I want to see the doctor I have to pay $75 a month in addition to charges for each office visit. This has become very common practice. Fortunately
I'm healthy enough that a Nurse Practitioner can meet my needs, and is better looking than the doctor.

[sugar land dave]

I spent 4 months reading the law and examining the policies before I chose for our family. I figured that it was very important to know how to make the new program work for us rather than just trusting that all would be okay. The law has worked in my favor due to me being uninsurable otherwise. I chose an HMO policy from the options given by the market. It holds down prices and has no deductible with a $1000 yearly maximum out of pocket for my wife and I combined or $500 per individual.

I did lose my five-star cardiologist, but was able to select from a list of 127 cardiologists in my metro area which included the head of the heart transplant team at a major hospital in the Medical Center, and another who has been head of most prominent cardiologist organizations during his long career. My existing nephrologist was listed on the plan so I kept him. The plan let me be referred to a top endocrinologist, a suburban audiologist who I preferred over the city ones, and paid for all tests the doctors wanted to run. It has let me know that it will pay for cardio rehabilitation if I feel that I am ready to give time to that.

Long story short, I cannot complain.

[SA_Steve]

how much per month ?

[mojo84]

The proposed Obamacare premium rates for 2016 are likely to see many double digit increases from the largest providers. The states with the largest average increases, as proposed, are New Mexico (51%), Tennessee (36%), Maryland (30%), and Oregon (25%). The final rates will be lower, but they may very well remain in the double-digits because insurers are seeing their first full year of claims data from ObamaCare’s exchanges, and the pool of insurance consumers on the exchanges are tending to be older and sicker than they were hoping to see.

The U.S. Department of Health and Human Services originally projected that for the exchanges to be financially stable; at least 40% of those enrolling in health care must be ages 18-35. So far, that figure is only 28%. But, as opponents of ObamaCare have been predicting for years, healthier and younger people have little incentive to join the exchanges because ObamaCare passes so much of the cost of more expensive patients onto them.

http://www.freedomworks.org/content/oba ... ble-digits" onclick="window.open(this.href);return false;

It came out recently Humana is on the block to be sold or merged with another insurance company. If it goes through, there will be even less competition. Whether you obtain an Obamacare subsidy or not, Aetna has be somewhat competitive and may be a viable option if you verify their provider network is adequate in your area.

The challenge at this point is that we are not in the enrollment period and it will take a qualifying event/condition in order to enroll between now and the next enrollment period.

Whether you get insurance through the exchange or not, expect health insurance premiums to continue to increase along with higher deductibles and fewer providers. Also, the subsidies for many are being reduced. The initial subsidy was a little like a drug dealer giving away a few doses of cocaine to get people hooked and then they start charging or charging more once they have a hooked customer.

Something most people, even agents, do not realize is the insurance carriers provider networks on the exchange plans can be very different from the off-exchange plans. Whether you go exchange or off-exchange to secure your coverage, make sure you verify your preferred docs, hospitals and other providers are in the insurance carriers network. This is something that doesn't standout at the time one is purchasing their insurance as the plan design and coverage can be the same for on and off exchange plans. However, the difference comes in the provider network. Many exchange plans utilize a narrow or skinny network which can severely limit one's options.

All that said, a few of my clients that have serious ongoing health conditions and are fairly young have benefited from being able to get coverage to it being somewhat more affordable than before. However, the majority of my clients have not received any benefit over what we had before Obamacare.

Another resource for info.

http://www.ncsl.org/research/health/ins ... quacy.aspx" onclick="window.open(this.href);return false;

Here is a dated article from the provider/ physicians perspective. Much of what it anticipates has been realized.

http://www.texmed.org/Template.aspx?id=29516#sidebar" onclick="window.open(this.href);return false;

Here is some current info to contrast against the previous old article posted.

http://www.texmed.org/Template.aspx?id= ... 20exchange" onclick="window.open(this.href);return false;


I take a different tact than others. I do not quote the Obamacare Exchange. I advise people to obtain an exchange quote if they are interested and need the subsidy while I obtain direct off exchange quotes from the carriers. Once we gather the quotes, I will set down with them to help them compare and choose which one works best for them. If they want me to work with them going forward on a plan they chose through the exchange, they can put my agent info in and I will be able to help service their account.

[FrogFan]

For the past two years, I've had to buy private insurance because I "retired" from my job, haven't landed a new one, and am unlikely to do so -- I'm 61. My wife and I have saved and invested well over the years, and we live comfortably. It's just the two of us on the insurance.

We bought our first private policy from Humana through ehealthinsurance right before Obamacare became effective, for $700 a month for a $10,000 deductible policy (these are approximate amounts). As soon as Obamacare became effective, the rate went up $100 per month. We had the option last year to renew that policy, which went up another $150 per month, or go to Obamacare. Without a subsidy, Obamacare was about $400 per month more expensive than the new rate for the old policy. Also, I go to an eye surgeon who doesn't accept any policy offered through the Obamacare exchange. He accepts my existing Humana policy. My GP only accepted a couple of the policies offered through Obamacare. I had to make sure I picked one he did accept.

I tried for a subsidy, but got caught up in the approval process and didn't want to risk running without insurance. I was also concerned about what SCOTUS would do with subsidies in Texas, so I decided to continue with the more expensive version of my existing policy. There is a long and frustrating story here about how to prove you don't have any taxable income to the Obamacare bureaucrats but I'll save everyone the pain of that unless there is interest.

My understanding is that my wife and I won't have any choice but to go with Obamacare next year (this November), as my existing policy will no longer be available, but based on what AJSully421 says above, maybe I can continue to avoid Obamacare by approaching the insurers directly? Also, I'm wondering now if I should continue to use ehealthinsurance. I've had two decent experiences with them; they navigate Obamacare for you, but I wonder if I'm paying more than I should by going through them.

I don't know what it was like to buy private health insurance before Obamacare, but I can say my experience has not been good. From my perspective, the government has made quite a mess of things.

[sugar land dave]

how much per month ?

On the first date?

[AJSully421]

jmra,

Thanks for your helpful input.

AJSully421,

Have you gotten any positive feedback regarding medical care from those on Obamacare? Or, are they suffering long waits in overcrowded conditions in clinics/hospitals?

Am I correct in assuming poverty level people are the ones to most benefit using Obamacare?

From what I gather too, (and correct me if I'm wrong) even lower middle class folk can't afford Obamacare.

Thanks!

Most of the feedback that I have received has been alright. Mostly from those who I enrolled on plans who made too much money to qualify for Medicaid, but could not afford traditional insurance before. Most were using the ER as a clinic, so anything is better than that. I sold a lot of HMOs to that crowd because they really need for someone like a Primary Care Physician to take charge and walk them through, or they would be going to a specialist at the drop of a hat. I did have a couple who ran off to the ER for extremely minor issues and got themselves in trouble with having to pay deductibles... it will take a decade to train that out of the folks who got used to using the ER as a clinic.

There are some long waits and overcrowding, because people who have never had insurance before now do, and they want to make sure they are getting their money's worth. Most were used to waiting hours in the ER for a muscle ache, so they are comparatively pleased to be able to see their Primary Care Physician instead.

Yes, the people who benefit the most from OC are typically those who are not totally dependent on the government, maybe they have a part-time job or something that just doesn't give them enough income to afford insurance. Before I got started I was very judgmental, but after the third or fourth case where I saw a single mother working two jobs to put food on the table and kids who worked hard on their school work and were dedicated... I got a good dose of humility. Most of the people who are getting subsidies are NOT welfare queens, they are the ones working hard, not demanding a handout.

You are correct, the people in the lower middle class, just to the point that they only get a small subsidy, are the ones getting the short end. They make too much to qualify for any real assistance, but they don't make enough to afford the new, highly inflated, premiums due to the things that an OC compliant plan has to offer.